Bundle
Bundle for NEONATAL exam ,latest updated
10 Items
NEONATAL NURSING, questions and answers with rated solutions
Neonatal Period -Defined as the first 28 days after birth -Newborn adapts to a brighter & cooler environment -Physiologic & behavioral changes occur qui... [Show More] ckly -The nurse & parents must be aware of any deviations from the norm for early identification & prompt interventions Assessment Findings -Transition -6-10 hours -Physiological changes -Periods of reactivity -Physical assessments -Reflexes Umbilical cord Vein carries oxygenated blood from placenta to uterus Ductus Venosus permits most of umbilical vein blood to bypass liver & merge with blood in vena cava -Reaches heart sooner Foramen ovale allows blood entering right atrium to cross to left atrium Ductus Arteriosus connects the pulmonary artery to the aorta, allowing for bypass of the pulmonary circuit Placenta supplies oxygen, nutrients & removes waste products Cardiovascular Adaptations ... At birth -Fetal circulation must convert to newborn -Placental pulmonary exchange -Release of epinephrine & norepinephrine -Stimulate increased cardiac output Cont.. -Umbilical cord is clamped -First breath taken & lungs begin to function -Pressure changes occur -Left atrium> right atrium -Foramen ovale closes -Oxygenated & non-oxygenated blood no longer mixes Cont.. -Ductus Arteriosus becomes functionally closed within the first few hours after birth -Closure is signaled by high oxygen content of aortic blood -Results from gas exchange in the lungs -Pulmonary vascular resistance decreases -Pulmonary blood flow increases & oxygen exchange occurs in the lungs Cont.. -Ductus Venosus closes within a few days after birth -Due to activation of functional liver -Liver takes over functions of placenta -Two umbilical arteries & one vein constrict at birth & become ligaments Additional CV Changes ... After birth -Heart Rate- 120-180bpm -Will decrease to 120-130bpm -Crying, movement & wakefulness will cause an increase in HR & blood pressure Cont.. -Difficulty compensating -Tachycardia may reflect: -Dehydration, CV disease, drug withdrawal -Bradycardia may reflect: -Apnea, hypoxia -Delayed cord clamping may improve newborn's CV/pulmonary adaptation Respiratory Adaptations -Hypercapnia, hypoxia & acidosis from normal labor trigger 1st breath & subsequent respirations -Also environmental factors e.g. noise & light -Surfactant provides the lungs with stability for gas exchange -Tension-reducing lipoprotein -Prevents alveolar collapse -Reduces the risk of atelectasis Cont... -Chest wall is "floppy" -Passage through birth canal helps to eliminate amniotic fluid in lungs -Thorax is intermittently compressed -If fluid is not removed, will result in tachypnea -RR> 60bpm -E.g. Cesarean Section After birth -Respirations are shallow & irregular -30-60bpm (may have short period of apnea; <15 sec.) -More active= the higher the RR Signs of Respiratory Compromise -Cyanosis -Tachypnea -Expiratory grunting -Sternal retractions -Nasal flaring -Labored breathing Periodic Breathing cessation of breathing that lasts 5-10 seconds without other s/s Requires close monitoring Thermoregulation -Process of maintaining balance between heat loss & heat production -Newborns at greatest risk within 12 hours of life -Pre-term greater risk -Range: 36.5-37.5°C 97.9-99.7°F Heat Loss -Lack inability to shiver -Limited use of voluntary muscles -Large body surface area -Lack subcutaneous fat -Unable to change position (can't conserve heat) -Inability to communicate temperature extremes -Limited metabolic stores (e.g. fat) Conduction Heat fluctuation between body surface when in contact with another -e.g. cold mattress -Use blankets Convection Flow of heat from body surface to cooler air -e.g. cool breeze flows over newborn -Warm oxygen, work inside isolette, move away from open doors/windows/fans Evaporation Loss of heat when liquid is converted to vapor -E.g. Amniotic fluid evaporates off of baby after birth -Keep cap on baby's head & dry after bathing with warm blankets Radiation Loss of heat to cooler, solid surfaces (not in direct contact with newborn) -E.g. Newborn placed in isolette next to cool window -Become cold, even though in isolette -Keeps cribs/isolette away from windows/walls/ac units Role of Brown Fat -Ability to produce heat -Through metabolic activity; oxidized -Found between scapulae, nape of neck, mediastinum, kidneys & adrenal glands -When a newborn is subjected to a cold environment: -Norepinephrine is released -Brown fat metabolism is stimulated -Cardiac output increases -Blood flow increases through brown fat -Blood becomes warmed d/t increased metabolic activity Hepatic System Adaptations -Liver assumes its normal function at birth -Iron is released & stored by liver until new red cell production -Liver releases glucose from glycogen stores for first 24 hours after birth for energy -Feedings help stabilize glucose Bilirubin -Liver is responsible for conjugation of bilirubin -Produced by breakdown of RBC's -Normally, circulates in plasma, taken up by liver cells, changed to water-soluble pigment & excreted in bile -Newborns produce twice as much as adults -Declines 10-14 days after birth Total bilirubin -Combination of direct (unconjugated; not soluble) & indirect (conjugated; water soluble) -Failure of liver cells to break down & excrete bilirubin lead to jaundice or icterus -Yellowing of skin, sclera, mucus membranes -Buildup of bilirubin levels in the blood -Kernicterus bilirubin induced brain dysfunction -Extreme high levels in blood Jaundice Risk Factors: -Fetal-maternal blood incompatibility -Prematurity -Breastfeeding -Drugs -Gestational Diabetes -Male gender -Trauma in birth -TORCH infection -Previous sibling -Asian or Native American decent GI System Adaptations At birth the newborn can: -Swallow, metabolize, absorb & digest food Bacterial Colonization -GI tract is sterile prior to delivery -During delivery newborn's gut is colonized with mother's & surrounding environments intestinal flora -C-Section patient's may take 6 months for flora to develop -initially obtain flora from environment Mucosal Barrier -Epithelial lining of intestines that prevents passage of harmful substances (e.g. bacteria) -Developed within in first week of life -Provides an environment where necessary flora can survive & harmful cannot -Human breast milk provides antibodies & additional substances that can also help protect the neonate against harmful substances Bowel ... Meconium -First stool passed -Greenish black -12-24 hours post birth Sterile Once feedings are initiated -Transitional stool occurs -Greenish-yellowish brown -Seedy Milk Stool -BF- yellow gold, loose, sour smelling -Formula- vary based on type, yellow-green, loose, unpleasant odor Renal System -Normally void immediately post delivery -Urine becomes concentrated ~ 3mos -6-8 voids/day is expected -Indicates adequate fluid intake -Additional Characteristics: -Low GFR -Limited excretion -Affect ability to excrete salt, water & drugs Immune System Function Poor immune function well into neonate period -Previously depended on intrauterine environment Natural Immunity Responses or mechanisms that do not require previous exposure to function appropriately -E.g. Newborn's skin & mucus membranes Acquired Immunity -Two processes -1- development of antibodies -2- Formation of lymphocytes to destroy harmful substance -Absent until first invasion of harmful substance -Newborn relies on immunoglobulin's for defense mechanisms -Antibodies -IgG, IgA, IgM -IgA found in human break milk Integument System Adaptations -Epidermis fully formed by 32 weeks gestation -Newborn skin: -Risk of injury from tape, monitors -handling increases risk -Sweat glands not fully functional until 2-3 years -Exposure to air after birth accelerates hair growth -Color changes with environment & health status -Birth -Skin is dark purple -With first breath Red -Should fade over first 24 hours Neurologic System Adaptations At birth: -Hear -Smell (mother's milk vs. others) -Touch (sensitivity to pain) -Vision (focus 7-12 inches away) -Smell develops over 72 hours (sour vs. sweet) -Reflex testing -Involuntary muscular response -Will indicate normal functioning CNS or reveal abnormalities First Period of Reactivity Birth to 30 minutes -Heart rate: 120 to 180 -Respirations: Irregular 60-80-activity; alert watching -Responsiveness: Reacts vigorously -Reflexes: rooting, sucking, moro, chewing, fine tremors -A time for parents/caregivers to interact with newborn & enjoy close contact -Initiation of breastfeeding Period of Decreased Responsiveness 30-120 minutes -Color: stabilizing, pink all over -Heart rate : slows to 120-130bpm -Respirations: slows to 30-50bpm -Responsiveness: Sleepy, decrease in activity & movements less frequent -A time for parents/caregivers to remain close & rest together after labor/birthing experience Second Period of Reactivity 2 to 8 hours -Color: quick color changes with crying/movement -Heart rate: varies with activity -Respirations: irregular with activity -Responsiveness: Reactive; shows interest in environment. Motor coordination increases -Meconium: Peristalsis increases, may pass -A good time for parents/caregivers to examine their newborn & ask questions Neurobehavioral Responses Orientation: -Response of newborns to stimuli -Validated by movement of eyes, head -Prefer human face & shiny objects Habituation -Ability to process & respond to visual/auditory stimuli -Block out external stimuli -Improves within 24 hours -Reflected by sleep patterns Neurobehavioral Responses Motor Maturity: -Evaluation of posture, tone, coordination & movements -Varies with age Self-Quieting: -Ability to quiet & comfort self -Consolability Social: -Ability to cuddle/snuggle when held -Important for parents to gauge ability to be caregivers Gestational Age Assessment Determines newborn's stage of maturity -Includes assessment of: -physical & neuromuscular maturity -Points given for each assessment parameter -Scores from each section are added together & correspond to gestational age in weeks Newborns classified as -Preterm/premature: before 37 weeks -Term- born between 38-42 weeks -Postterm/postdate- born after 42 weeks -Postmature- born after 42 weeks & displays signs of placental aging APGAR Scoring Evaluates newborn 1 & 5 minutes after birth Assess: A- Appearance P- Pulse G-Grimace (reflex irritability) A- Activity (muscle tone) R- Respiratory (effort) 0= absent or poor 2= normal response Totals: 8-10= normal newborn score 4-7= moderate difficulty; need intervention 0-3= severe difficulty adjusting; need intervention Length & Weight Taken soon after birth Length: head of newborn to heel, unclothed Place supine & extend leg fully Normal 19-21 inches Weight: Use digital scale Normal 6-9 lbs Typically lose 10% weight by day 4 & regained by day 10 Normal Newborn Ranges Temp: 97.9-99.7°F (36.5-37.5°C) HR: 120-160 bpm (up to 180 with crying) Listen for apical (4th intercostal space; full minute) RR: 30-60 at rest (will increase with crying) Assess for full minute (may be slightly irregular; diaphragmatic) BP: 50-75 systolic/ 30-45 diastolic Usually Taken: -On admission to nursery -q 30 minutes until newborn has been stable for 2 hours -Then, once q 4-8 hours Maintaining a Patent Airway Immediately after birth: -Newborn suctioned to remove fluids from mouth & nose -Mouth first -Reduces risk of aspiration -Always keep bulb syringe at the bedside in case of sudden choking/blockage in the nose Nasal/Oral Suctioning -Obligatory nose breathers - Position head to side -Compress bulb syringe first & insert between cheek & gum -Do not insert into back of throat -Remove syringe & expel contents into an emesis basin Vitamin K -Promotes blood clothing -Vitamin K supply not sufficient until 1 week -Single IM dose -Research currently looking for oral forms Eye Prophylaxis -Erythromycin or Tetracycline -US mandates all receive within 1-2 hrs after birth -Prevents Ophthalmia Neonatorum -Conjunctivitis that can cause blindness within 1- 10 days Anthropometric Measurements -Length -Weight -Head circumference -32-38cm (13-15in) -Measure at head's widest diameter -Chest circumference -30-36cm (12-14in) -2-3 cm less than the head -Place tape around chest at nipple line (unclothed) Skin -Check turgor (chest/abdomen) -Lanugo may be present -Fine hair -Should be warm, dry & intact -Acrocyanosis? -Mottled blue color/ persistent cyanosis -Normal & intermittent Harlequin Sign -Color change -Dilated blood vessels on ONE side of body -Immature autoregulation of blood flow -Common in low birth weight newborns Head Should be symmetric & round Fontanels: -Anterior -Diamond shape; closes at 18-24 mos -Posterior -Triangular; closes 6-12 weeks Palpate both -Should be soft, flat, open -Palpate skull, should feel smooth Caput Succedaneum A localized soft tissue edema of the scalp. Cephalohematoma is a collection of blood between the periosteum and the skull bone that it covers. It does not cross the suture line. Head ... Microcephaly -Circumference is less than 10% of normal parameters -Associated with poor brain development or genetic disorders Macrocephaly -Circumference is more than 90% of normal -Usually r/t hydrocephalus Face & Nose Observe for fullness & symmetry Forceps in delivery: -May cause facial nerve paralysis -Observe nose for size, symmetry & lesions Should be: -Midline -Patent nares -Obligate nose breathers Mouth -Lips should be intact & midline with no lesions -Lips should encircle around finger; vacuum -Inspect inside of mouth: -Intact gag swallow & sucking reflex -Uvula midline -Pink, moist with minimal saliva Abnormalities: -Epstein's pearls -Erupted teeth -Thrush -Candida albicans Eyes -Clear & symmetrically placed -Blink reflex -Bring object close to eye & should blink -Pupillary reflex -+PEARL May be some edema d/t birth process Abnormalities Transient Strabismus -Searching Nystagmus- involuntary repetitive eye movement -Chemical conjunctivitis -Lid edema & discharge from both eyes 24 hrs post eye prophylaxis placement Neck -Creases should be noted -Almost appears non-existent -Capable of holding head midline -Clavicles should be straight & intact Chest -Should be 2-3 cm smaller than head diameter -Xiphoid process may be prominent at birth -Nipples may be engorged & secrete white substance -Goes away in a few weeks, d/t excess maternal estrogen Auscultate: -Heart & lung sounds -Murmur 12 hours after birth should be reported Supernumerary Nipple extra nipple along the the embryonic "milk line" on the thorax or abdomen; a congenital finding Abdomen & Umbilical Cord -Inspect for shape & movement -Note abdominal breathing -Auscultate bowel sounds -Palpate for tenderness/masses Inspect umbilical cord -Two arteries & one vein Note any bleeding -abnormal Should fall off within 2 weeks Genitalia- Male Inspect penis/scrotum Scrotum usually large Should be no bulging, edema, discoloration Palpate testes Firm & equal size Hypospadias Epispadias Inspect anus for patency Passage of meconium would indicate this Hypospadias A congenital condition in the male where the urethra ends on the ventral side of the glans penis, anywhere along the penile shaft, on the corona, or on the perineum Epispadias Abnormal opening of the penile urethra on the superior/dorsal side of the penis due to faulty positioning of the genital tubercle Genitalia- Female Inspect external surfaces only Will be engorged with labia edematous d/t maternal hormones Pseudomenstruation white/ & bloody d/c normal in first few weeks; no treatment Abnormalities ... Ambiguous genitals xx female exposed to very high levels of androgens Rectovaginal fistula with feces abnormal opening between the vagina and rectum Imperforate hymen a hymen that completely closes the introitus Extremities Inspect upper & lower extremities Note: Number of digits Polydactyl Syndactyly Palmar creases Simian line ROM Erb's Palsy Affected arms hangs & adducted Recovery in 3-6 months Polydactyl Extra digits Syndactyl Fusion of digits Single Transverse Palmar Crease simian crease Erb's Palsy Paralysis of the upper plexus incl. 5th and 6th cervical nerves; C7 may be invol. in some case Ortolani Maneuvers Grasp inner aspect of thighs & abduct while applying upward pressure Clicking or clucking is abnormal Suggests hip dysplasia Barlow Maneuvers Grasp inner aspect of thighs & adduct while applying outward & downward pressure Feel for femoral head slipping out of acetabulum [Show Less]
- Exam
- $14.45
- 0
- 155
Neonatal & Infant Neurosongraphy, questions and answers, graded A+
Which of the following indicator lines (A through C) corresponds with the accompanying ultrasound image? A. Image slice A B. Image slice B C. Image sl... [Show More] ice C Image slice B Which of the following structures is identified by the indicator line in this parasagittal plane ultrasound image? Choroid plexus within atrium of lateral ventricle This ultrasound image was taken using standard neonatal and infant neurosonography imaging conventions. Which part of the brain is identified by the indicator line in the accompanying ultrasound image? Right frontoparietal region Which of the following indicator lines (A through C) corresponds with the accompanying ultrasound image? Image slice C Which of the following structures is identified by the indicator line in this midline-sagittal plane ultrasound image? Corpus Callosum Which of the following structures is identified by the blue dot indicators in this parasagittal plane ultrasound image? Caudothalamic groove Which of the following structures is identified by the indicator line in this coronal plane ultrasound image? Cavum septi pellucidi Which of the following structures is identified by the indicator line in this coronal-oblique plane ultrasound image? Third ventricle Which of the following structures is identified by the indicator line in this coronal-oblique plane ultrasound image? Cerebellar vermis Which of the following indicator lines (A through C) corresponds with the accompanying ultrasound image? Image slice C Which of the following structures is identified by the indicator arrow in this midline sagittal plane brain illustration? Cavum septi pellucidi Which of the following structures is identified by the indicator line in this oblique-sagittal plane ultrasound image? Caudothalamic groove Which of the following structures is identified by the indicator arrow in this coronal plane brain illustration? Cavum septi pellucidi Which of the following indicator lines (A through C) corresponds with the accompanying ultrasound image? Image slice C Which of the following statements best characterizes neonatal and infant neurosonography? Neonatal neurosonography is an element of the RANS protocol Which of the following statements best characterizes ventriculomegaly? The anterior-horn width is a parameter used to detect ventriculomegaly Which of the following anatomic locations is a common site of brain hemorrhage in premature infants? Caudothalamic groove Which of the following statements best characterizes the normal pathway of cerebrospinal fluid (CSF)? The foramina of Monro transport CSF from the lateral ventricles to the third ventricle Which of the following statements best characterizes standardized ultrasound transducer orientation for performing neonatal and infant neurosonography in a coronal plane? Orient the transducer indicator towards the patient's anatomic-right side Which of the following statements best characterizes the distribution of choroid plexus within the ventricular system? Choroid plexus is most commonly found in the atrium of the lateral ventricles [Show Less]
- Exam
- $14.45
- 0
- 170
CCRN Neonatal questions and answers, graded A+
A deformation is a(n) abnormality caused by unusual mechanical forces on normal tissue. A low birth weight infant's temperature increases during sk... [Show More] in-to-skin care. This is an example of heat transfer by conduction. At the onset of labor the release of catecholamines stimulates increased absorption of lung fluid. An edematous, bruised lesion on the right anterior scalp where the vacuum was applied. This lesion has clearly demarcated edges, is firm to touch, and does not cross the suture line. This is best described as a cephalohematoma. An infant born at 40 5/7 weeks gestation and weighed 5 lbs 2oz (2,360 grams). In completing a gestational age assessment on this infant, you would identify her as term, small for gestational age. During fetal life, the ductus arteriosus diverts blood flow from the pulmonary artery to the descending aorta. Expected findings in a neonate born to a mother who received magnesium sulfate in labor include hypotonia. Eye prophylaxis with a single-use dose of sterile ophthalmic ointment containing 1% tetracycline or 0.5% erythromycin is usually administered within the first few hours of birth to prevent an eye infection caused by gonorrhea. Following a birth complicated by shoulder dystocia, the neonate should be assessed for Erb's palsy. Preeclampsia may result in all of the following fetal conditions growth restriction, hypoxia/neurological injury, prematurity. Hyperthermia is defined as an axillary temperature greater than 99.5ºF (37.5ºC). The MOST common cause of hyperthermia in the newborn is environmental. In the immediate newborn transition period, the ability to maintain functional residual lung capacity is most dependent upon an adequate amount of alveolar surfactant. Neonates at risk of hypoglycemia should have their glucose levels evaluated within 2 hours of life because blood glucose levels reach their lowest point within one to two hours after delivery. Polycythemia in the immediate newborn period is often associated with infant of a diabetic mother. Symptoms of mild perinatal asphyxia include hyperalert state and jitteriness. The condition in which the newborn's immature hypothalamus does not regulate peripheral blood vessels, resulting in a vasoconstriction on one side of the body with a vasodilation on the opposite side of the body is called harlequin phenomena. The following conditions may all lead to metabolic acidosis loss of HCO3/excess acid load d/t prematurity, renal tubular necrosis, severe diarrhea, hypoxia, hypoperfusion, inborn errors of metabolism, caloric deprivation, intolerance of cow's milk protein. The full newborn cardiovascular assessment includes auscultation, inspection, and palpation. The point of maximum impulse is usually palpable and can be auscultated in the third to fourth intercostal space and left of the midclavicular line. The neonate born to a mother with uncontrolled diabetes mellitus should be evaluated for congenital malformations. You are the nurse caring for a 38 weeks gestation, female infant, who was born one hour ago in the parking lot of the emergency room. On admission to the nursery, the neonate's rectal temperature was 95ºF (35ºC). You recognize that cold stress may predispose the infant to increased oxygen consumption and hypoxia. A full term neonate who presents at six hours of age with increasingly labile oxygenation that appears disproportionate to the pulmonary disease should be evaluated for pulmonary hypertension of the newborn. The development of pneumonia in chronically ventilated infants is most commonly associated with which of the following organisms? Ureaplasma urealyticum Antenatal steroids enhance lung maturation by increasing the number of type II pneumocytes in the lung. Mean airway pressure is defined as the pressure transmitted to the lung throughout the respiratory cycle. Many infants with the diagnosis of persistent pulmonary hypertension (PPHN) will have pharmacologic support. Identify the medication that is a direct-acting vasodilator and acts by relaxing pulmonary vessel musculature. Nitric oxide The following arterial blood gas results: pH 7.28, PaO2 74, PaCO2 55, HCO3- 21 and base deficit -4 indicate respiratory acidosis. Nastassia is a one-hour-old neonate, born at 39 weeks gestation by primary cesarean birth for fetal bradycardia. She was hypotonic at birth with gasping respirations and a heart rate of 80. She was provided bulb suctioning and bag mask ventilation and recovered by five minutes of life. On admission to the NICU, her temperature was 36° C. After admission to the NICU, her arterial blood gas is pH: 7.19, PCO2: 63, HCO3: 14. The correct interpretation of this blood gas is mixed respiratory and metabolic acidosis. Which statement is most accurate when identifying the pathophysiology of transient tachypnea of the newborn (TTN)? Labor enhances the process of fetal lung fluid absorption During which phase of fetal pulmonary development do the type II pneumocytes become numerous and begin to produce and store surfactant? Canalicular phase An absence of air flow despite respiratory effort is an example of which apnea classification? Obstructive apnea Continuous positive airway pressure (CPAP) improves oxygenation by improving the ventilation-perfusion ratio. The functional residual capacity in a newborn infant should be approximately 30 ml/kg. A 29 week gestation infant who displays symptoms of a pulmonary hemorrhage should be evaluated for patent ductus arteriosus. The most significant role of surfactant in neonatal lung development is to maintain alveolar stability by decreasing surface tension. Most respiratory disorders result in a ventilation-perfusion mismatch. Ideally, the ventilation-perfusion ratio should be 1 to 1 A neonate at 12 hours of life with meconium aspiration syndrome who has been intubated since birth suddenly develops severe respiratory distress, tachycardia, and hypotension. Which diagnosis would be least likely to be in the differential? Intraventricular hemorrhage Which of the following conditions is not an air leak? Pneumatosis intestinalis The decision to intubate an infant born through thick meconium should be based on the infant's response to stimulation and bag and mask ventilation. The type of patient-triggered ventilator that applies a constant pressure during inspiration and terminates with a decrease in air flow, thereby decreasing the work of breathing, is a(n) pressure support ventilation. Neonates receiving surfactant are at increased risk of developing pulmonary hemorrhage. A discrepancy greater than 10 mm Hg between the blood pressure in the upper and lower extremities is indicative of which defect? Coarctation of the aorta In order to pass a pulse oximetry screening for critical congenital heart disease (CCHD), which oxygenation and percentage of variance is required in the right hand and foot? Less than 95% O2 saturation and greater than 3% variance A neonate at 10 hours of age is found to be cyanotic and without respiratory distress symptoms. The EKG and chest x-ray are normal. The administration of oxygen is not relieving the cyanosis. The healthcare provider should have a high index of suspicion for which of the following defects? Transposition of the great vessels A right-to-left shunt will be seen with pulmonary stenosis. Appropriate nutritional management of the neonate with congestive heart failure is best achieved by which of the following? Individualizing to minimize energy consumption At approximately _____ weeks of gestation the heart has developed a fully functioning electrical conduction system. 10 It is important to evaluate the neonate with critical pulmonary stenosis for symptoms of right-sided congestive heart failure. One of the medications given to cause constriction and closure of the ductus arteriosus in the neonate is indomethacin. Parallel circulations in which there are separate pulmonary and systemic circulatory systems occur in transposition of the great vessels. Pulmonary venous congestion is most commonly identified with which of the following defects? Hypoplastic left heart Pulse oximetry screening for critical congenital heart disease (CCHD) is most accurate when performed when the infant is how many hours of age? 24 hours or more The best option for volume replacement in an infant with disseminated intravascular coagulopathy is FFP (fresh, frozen plasma). The major structural anomaly associated with total anomalous pulmonary venous return (TAPVR) includes pulmonary veins failing to be incorporated in the left atrium. The valve located between the left atrium and left ventricle is called the mitral. Which is the most prevalent theory of the etiology of congenital heart disease? Multifactorial etiology How does the neonate respond to increase cardiac output? Tachycardia is the main neonatal cardiac response to increase cardiac output. Which of the following defects increases blood flow to the lungs? Patent ductus arteriosus Which of the following is the most controversial management strategy for treatment of congestive heart failure in the preterm neonate? Digoxin therapy What are the symptoms of congestive heart failure? Tachypnea, tachycardia, central or prolonged peripheral cyanosis, BP higher in R arm than either leg, arrhythmias, poor feeding, cardiomegaly on CXR, hepatomegaly, pulmonary fine or coarse rales. Which of the following organs forms first in the embryo? Heart Which statement lists the four defects that make up the tetralogy of Fallot? Pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, ascending aorta overriding the ventricular septal defect Which term describes the combination of the pressure on the ventricular walls caused by the volume of blood inside those walls and follows the principles of the Frank-Starling law? Preload Which types of shock are commonly seen in the infant who is septic? Distributive and hypovolemic With a complete endocardial cushion defect, blood will flow freely among all four chambers of the heart. An infant whose birth weight is at what percentile on the growth chart is at increased risk for hypoglycemia due hyperinsulinism? 97th At how many weeks gestation is suck-swallow-breathe coordination present? 34-36 Compared to full term formulas, preterm formulas contain more calories and increased protein. Complications of percutaneous central venous lines catheter migration. Depending on the amount of weight loss, electrolyte values, and markers of renal function, fluid is usually administered at which rate in the first 48 hours of life? 60-100 ml/kg/day Disadvantages associated with continuous gavage feedings include all of the following EXCEPT? Decreases in the amount of gastric acid in the stomach Gluconeogenesis is the process of converting non-glucose precursors to glucose. In which of the following conditions is the neonate MOST at risk for hypokalemia? Increased gastrointestinal losses Insensible water losses occur primarily through respiratory and cutaneous routes. Jeremiah was born via emergent cesarean birth at 38 weeks gestation after a complete abruption. He required a full resuscitation, and his Apgar scores were 1 at 5 minutes, 3 at 7 minutes, and 5 at 10 minutes. He is currently on ventilatory support with a diagnosis of hypoxic ischemic encephalopathy. Jeremiah is MOST at risk for hypoglycemia because damage to the liver may impair synthesis of enzymes that facilitate glucose homeostasis. One of the advantages human milk has over formula is that it contains very long-chain fatty acids. Patient care management for the neonate with hypernatremia often includes monitoring for hyperglycemia and hypocalcemia. Preterm neonates have fewer glomeruli and tubular immaturity, which contribute to which of the following physiologic processes? Retention of sodium and bicarbonate, free water excretion, and decreased renal concentrating capacity Signs of renal compromise or severe fluid deficit will often include a urine output of less than 0.5 ml/kg/hour. Symptoms of hyperkalemia include electrocardiographic changes and dysrhythmias. The purpose of trophic feeds is to stimulate functional development of the GI tract. What is the best treatment option for severe intractable hyperkalemia? Peritoneal dialysis What is the timeframe for early hyponatremia in the neonate? 1-2 days When caring for a newborn on an insulin infusion, the glucose levels should be monitored how often during the initial titration of the drip? Every 15 minutes Which of the following does NOT cross the placenta from the mother to the fetus? Insulin Which of the following parties is MOST essential to the feeding experience of the NICU infant? Parent/family member Which substrate is the major source of fuel to the brain? Glucose Who should dictate the feeding experience in the NICU? NICU infant A 38-week gestation neonate presents to the NICU with respiratory distress symptoms and anuria. On physical examination, she is found to have hypertension, bilateral flank masses, and hypoplastic lungs. The best diagnosis for this presentation is polycystic kidney disease. A newborn's maternal history includes oligohydramnios sequence. What might be an expected finding on physical exam? Compressed facial features potter's sequence;bilateral renal agenesis, atresia of the ureter or urethra, polycystic or multicystic kidney disease, renal hypoplasia, amniotic rupture, maternal hypertension/pre-e A priority of management for the neonate diagnosed with polycystic kidney disease is treatment of systemic hypertension. monitoring and treatment of hypertension, nephrectomy sometimes indicated, peritoneal dialysis Clinical manifestations of hypothyroidism include decreasing body growth and enlarged tongue. Clinical presentation of acute renal failure includes all of the following EXCEPT serum creatinine <1.5 mg/dl (132.6 μmol/L). oliguria, normal urine output, elevated creat, polyuria, hematuria, proteinuria, fluid overloead, dehydration, vomiting, poor eating, elevated medication levels Clinical presentation of renal vein thrombosis includes hematuria and anemia. hematuria, flank mass, thrombocytopenia, transient hypertenion, urine output of <1 ml/kg/hr, anemia During pregnancy, maternal ingestion of goitrogenic substances such as iodide or lithium may lead to which of the following endocrine conditions? Transient congenital hypothyroidism Management of the patient with bladder exstrophy includes covering the defect with plastic wrap. Potential etiologies of Intrarenal AKI Polycystic kidneys, Asphyxia, Nephrotoxic medications Potential etiologies of Postrenal AKI Posterior urethral valves, Fungal infections, neurogenic bladder Potential etiologies of Prerenal AKI Dehydration, Hemorrhage, Capillary leak The compromised neonate has difficulty regulating acid-base homeostasis due to decreased ability to handle acid load. The glomerular filtration rate doubles by the end of the second week of postnatal life because of increased glomerular surface area. The neonate has difficulty responding to large fluid loads due to a(n) decreased tubular sensitivity to aldosterone. The new classification for acute kidney injury (AKI) is based on urine output and change in serum creatinine level. The renin-angiotensin-aldosterone system is responsible for regulating sodium, potassium, and regional blood flow. Thyroid hormones are required for maturation of which of these systems? central nervous system. What is the MOST common type of acute renal failure in the neonatal period? Prerenal When performing the initial physical assessment of a newborn, the nurse notices the genitalia are atypical. Which condition might be responsible for this disorder? Congenital adrenal hyperplasia Which of the following explains why a preterm infant is at greater risk for negative sodium balance? There is an increased proportion of water in the extracellular fluid compartment. Which of the following is a common abnormality associated with a hypospadias? Chordee Which of the following is a prerenal cause of acute renal failure? Hemorrhage failure of autoregulation to maintain renal blood flow and GFR; hypoperfusion; result of hypovolemia; hypotension Which of the following is an etiology for postrenal kidney failure? Fungal infection Urinary tract abnormalities, extrinsic obstruction of the urinary tract, fungal infections A common organism responsible for early onset sepsis is E. coli. MOST common is GBS [Show Less]
- Exam
- $16.95
- 0
- 120
Neonatal Terminology questions and answers, all correct
perinatal Referring to the period of time surrounding an infant's birth, from the last two months of pregnancy to the first 28 days of life neonata... [Show More] l Of or relating to the first 28 days of an infant's life extrauterine Located or occurring outside the uterus. aspiration The sucking of fluid or a foreign body into the airway when drawing breath. thermogenesis Generation or production of heat, especially by physiological processes. hypoglycemia The condition called hypoglycemia is literally translated as low blood sugar. Occurs when blood sugar (or blood glucose) concentrations fall below a level necessary to properly support the body's need for energy and stability throughout its cells. rales A type of abnormal lung sound heard through a stethoscope. May be sibilant (whistling), dry (crackling) or wet (more sloshy) depending on the amount and density of fluid refluxing back and forth in the air passages. rhonchi a continuous snorelike sound in the throat or bronchial tubes, due to a partial obstruction acrocyanosis a decrease in the amount of oxygen delivered to the extremities. The hands and feet turn blue because of the lack of oxygen. Decreased blood supply to the affected areas is caused by constriction or spasm of small blood vessels. Apgar score a numerical expression of an infant's condition, usually determined at 60 seconds after birth and then five minutes after birth, based on heart rate, respiratory effort, muscle tone, reflex irritability, and color. circumoral cyanosis blueness around the mouth flea-bite dermatitis look like flea bites - blanched, wheelike appearance. May have tiny vesicles with small amounts of clear fluid. Rash appears on the diaper area, abdomen, thorax and back. no treatment is necessary: look like flea bites - blanched, wheelike appearance. May have tiny vesicles with small amounts of clear fluid. Rash appears on the diaper area, abdomen, thorax and back. no treatment is necessary vascular nevi A birthmark arising either as a developmental abnormality or as a postnatal benign neoplasm of a blood vessel. port wine stain Also known as a nevus flammeus. A common congenital vascular malformation involving mature capillaries, ranging from pink (salmon patch) to dark bluish red (port-wine stain) and usually occurring on the face and neck. Mongolian spots a smooth, brown to grayish blue nevus, consisting of an excess of melanocytes, typically found at birth in the sacral region in Asians and dark-skinned races; it usually disappears during childhood. May be mistaken for bruising. marbling In the neonate, it a common occurence when the baby gets cold. There are irregular areas outlined by pinkish or faintly purplish capillary network. Also known as mottling. Harlequin color a temporary flushing of the skin on one lower side of the body with pallor on the other side. Commonly seen in normal young infants, it disappears as the child matures. caput succedaneum edema occurring in and under the fetal scalp during labor. cephalohematoma A blood cyst, tumor, or swelling of the scalp in a newborn due to an effusion of blood beneath the pericranium, often resulting from birth trauma strabismus Strabismus is a condition in which the eyes do not point in the same direction. It can also be referred to as a tropia or squint. subconjunctival hemorrhage A bright hemorrhagic patch on the bulbar conjunctiva caused by rupture and bleeding of a superficial small capillary, due to increased pressure; Occur in newborns as a bright red sickle-shaped hemorrhage at the margin of the cornea and conjunctiva, attributed to abrupt pressure changes over the infant's body during delivery ptosis the term used for a drooping upper eyelid retractions refers to the drawing in of soft tissues of the chest - you'll see the babys chest suck in between his or her ribs when he/she is in respiratory distress Nasal flaring An increase in nostril size with breathing, a sign of respiratory distress Silverman-Anderson index A five item system for evaluating breathing of premature infants: 1) chest retraction 2) retraction of lower intercostal muscles 3) xiphoid retraction 4) nasal flaring on inhalation 5) grunt on exhalation. Each one is scored, low is best Epstein's pearls Multiple small white epithelial inclusion cysts found in the midline of the palate in most newborns. Erb's palsy paralysis of the upper roots of the brachial plexus, caused by birth injury. polydactylism a congenital physical anomaly in humans having supernumerary fingers or toes syndactylism Webbing or fusion of the fingers or toes, involving soft parts only or including bone structure hypospadias a developmental anomaly in which the urethra opens inferior to its normal location; usually seen in males, with the opening on the underside of the penis or on the perineum. On females the urethra opens into the vagina. epispadias congenital absence of the upper wall of the urethra, occurring in both sexes, but more often in the male, with the urethral opening somewhere on the dorsum of the penis Moro reflex a normal mass reflex in a young infant (up to 3 to 4 months of age) elicited by a sudden loud noise, such as by striking the table next to the child, or raising the head slightly and allowing it to drop. A normal response consists of flexion of the legs, an embracing posture of the arms, and usually a brief cry startle reflex A reflex seen in normal infants in response to a loud noise. The infant with make a sudden body movement, bringing the legs and arms toward the chest tonic neck reflex extensions of the arm and sometimes of the leg on the side to which the head is forcibly turned, with flexion of the contralateral limbs; seen normally in the newborn. rooting A reflex seen in newborn babies, who automatically turn their face toward the stimulus and make sucking (rooting) motions with the mouth when the cheek or lip is touched. The rooting reflex helps to ensure breastfeeding Babinski reflex dorsiflexion of the big toe on stimulation of the sole, occurring in lesions of the pyramidal tract, although a normal reflex in infants. Dubowitz score A method of clinical assessment in the newborn from birth until five days old that includes neurological criteria for the infant's maturity and other physical criteria to determine gestational age. Ballard scale The Ballard Maturational Assessment, Ballard Score, or Ballard Scale is a commonly used technique of gestational age assessment. It assigns a score to various criteria, the sum of all of which is then extrapolated to the gestational age of the baby. These criteria are divided into Physical and Neurological criteria. This scoring allows for the estimation of age in the range of 26 weeks-44 weeks. The New Ballard Score is an extension of the above to include extremely pre-term babies i.e. up to 20 weeks. square window sign Part of the Ballard Score; Wrist flexibility and/or resistance to extensor stretching are responsible for the resulting angle of flexion at the wrist. The examiner straightens the infant's fingers and applies gentle pressure on the dorsum of the hand, close to the fingers. From extremely pre-term to post-term, the resulting angle between the palm of the infant's hand and forearm is estimated at; >90°, 90°, 60°, 45°, 30°, and 0°. The appropriate square on the score sheet is selected. popliteal angle Another part of the Ballard Score; This maneuver assesses maturation of passive flexor tone about the knee joint by testing for resistance to extension of the lower extremity. With the infant lying supine, and with diaper re-moved, the thigh is placed gently on the infant's abdomen with the knee fully flexed. After the infant has relaxed into this position, the examiner gently grasps the foot at the sides with one hand while supporting the side of the thigh with the other. Care is taken not to exert pressure on the hamstrings, as this may interfere with their function. The leg is extended until a definite resistance to extension is appreciated. In some infants, hamstring contraction may be visualized during this maneuver. At this point the angle formed at the knee by the upper and lower leg is measured. scarf sign More to the Ballard Score: This maneuver tests the passive tone of the flexors about the shoulder girdle. With the infant lying supine, the examiner adjusts the infant's head to the midline and supports the infant's hand across the upper chest with one hand. the thumb of the examiner's other hand is placed on the infant's elbow. The examiner nudges the elbow across the chest, felling for passive flexion or resistance to extension of posterior shoulder girdle flexor muscles. circumcision The surgical removal of the foreskin of the penis or prepuce. polycythemia an increase in the total cell mass of the blood, excessive red blood cells hypoglycemia literally translated as low blood sugar. Hypoglycemia occurs when blood sugar (or blood glucose) concentrations fall below a level necessary to properly support the body's need for energy and stability throughout its cells. transient tachypnea of the newborn a respiratory problem seen in the newborn shortly after delivery. It consists of a period of rapid breathing (higher than the average 40-60 times per minute). It is likely due to retained lung fluid, and common in 35+ week gestation babies who are delivered by caesarian section without labour. Usually, this condition resolves over 24-48 hours. Treatment is supportive and may include supplemental oxygen and antibiotics. esophageal atresia a congenital medical condition (birth defect) which affects the alimentary tract. It causes the esophagus to end in a blind-ended pouch rather than connecting normally to the stomach pneumothorax a collection of air or gas in the pleural cavity of the chest between the lung and the chest wall, a hole in a lung(occasionally a result of overdistention of the lungs, caused by improper resuscitation) leading to collapse of the lung hyperbilirubinemia Elevation of the bilirubin level in the blood of the newborn, which results in yellowish staining of the skin and whites of the newborn's eyes. Neonatal jaundice, common, occurring in almost every newborn as hepatic machinery for the conjugation and excretion of bilirubin does not fully mature until approximately two weeks of age. kernicterus damage to the brain centers of infants caused by increased levels of unconjugated bilirubin phototherapy light therapy, used to treat jaundice erythroblastosis fetalis A grave hemolytic disease of the newborn fistula an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons. diaphragmatic hernia a defect or hole in the diaphragm that allows the abdominal contents to move into the chest cavity. Treatment is usually surgical. imperforate anus birth defect in which the rectum is malformed, no anal opening kangaroo care a way of holding a preterm or full term infant so that there is skin-to-skin contact between the infant and the person holding it. The baby, wearing only a diaper, is held against the parent's bare chest. Kangaroo care for preterm infants is typically practiced for two to three hours per day over an extended time period in early infancy. With babies who are medically stable, there is no maximum duration for kangaroo care, some parents may keep their babies in-arms for many hours per day. meconium aspiration occurs when infants take meconium into their lungs during or before delivery omphalocele congenital defect - an opening in the abdominal wall leading to herniation of the abdominal contents through the navel meningomyelocele Protrusion of the membranes that cover the spine but some of the spinal cord itself through a defect in the bony encasement of the vertebral column. The bony defect is spina bifida anecephaly the absence of a large part of the brain and the skull microcephaly a neurodevelopmental disorder in which the circumference of the head is more than two standard deviations smaller than average for the person's age and sex. hydrocephaly also known as "water on the brain," is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain. Cleft lip/cleft palate cleft is a fissure or opening—a gap. a type of clefting congenital deformity caused by abnormal facial development during gestation hip dysplasia The abnormal formation of the hip joint in which the ball at the top of the thighbone (the femoral head) is not stable within the socket (the acetabulum). The ligaments of the hip joint may also be loose and stretched macrosomia Overly large body. A child with macrosomia has significant overgrowth thrush A yeast infection of the mouth and throat. Thrush can also be associated with yeast infection of the esophagus. Thrush appears as creamy white, curd-like patches on the tongue and inside of the mouth and back of the throat. In individuals with impaired immune systems, yeast infections are more common [Show Less]
- Exam
- $10.45
- 0
- 160
Neonatal Sepsis questions and answers with complete top solutions
Define neonatal sepsis Clinical syndromes of bacteremia characterized by signs and sxs of infection in the first FOUR weeks of life. Differentiate ... [Show More] early vs late onset sepsis. Early: 0-7 days Late: >/= 7 days Risk Factors: Early: prematurity, amnionitis, maternal infection Late: prematurity Source: Early: maternal genital tract Late: environmental (nosocomial) Presentation: Early: Multisystem, pneumonia frequent Late: Slowly progressive focal, meningitis frequent Can present with a seizure. Mortality: Early: 5-50% Late: 10-15% What are the organisms most commonly responsible for the infections in neonatal sepsis? 1. Group B Strept - Ampicillin 2. E. Coli - Gentamycin 3. Listeria 4. H influenza, S. pneumonia, N. Meningitis 5. Viral - RSV, HSV, Enterovirus What percentage of deaths in neonates are a result of sepsis? 37% of all neonatal deaths What are the maternal risk factors associated with neonatal sepsis? 1. Intrapartum maternal infection - purulent, foul smelling, fever, leukocytosis 2. Premature rupture of membranes 3. Prolonged rupture of membranes (>12 hours) 4. Premature onset of labor (<37 weeks) 5. Maternal UTI. What are the neonatal risk factors for sepsis? 1. Low birth weight baby 2. Perinatal asphyxia 3. Male gender What are the symptoms of neonatal sepsis? 1. CNS - lethargy, Refusal to suck, not arousable, poor or high pitched cry, irritable, seizures. 2. CVS - pallor, cyanosis, cold and clammy. 3. Respiratory - tachypnea, apnea (most common), grunt, retractions. 4. GI - vomiting/diarrhea/abdominal distension 5. Hematological - bleeding, jaundice 6. Skin - rashes, purpura, pustules (microvascular clots throughout the body.) What are some symptoms of sepsis according to WHO? 1. RR >60/min 2. Retraction, flaring, grunting 3. Cyanosis 4. Temp - fever or more common hypothermia 5. Convulsions, lethargy or unconscious 6. Reduced movements/activity 7. Can't feed / suck 8. Bulging fontanels What are some other symptoms of sepsis? 1. Abnormal HR characteristics 2. Reduced capillary refill time 3. Metabolic acidosis due to decreased CO perfusion Is hypotension a sign of sepsis? Yes, but a very late sign. What is a typical clinical presentation of an infant with sepsis? 1. Temp >100.4 2. Poor feeding 3. Signs of shock 4. Tachycardia - compensated shock What are the direct methods of detecting sepsis? 1. Blood Cultures 2. CSF Cultures 3. Urine Culture What are some major risk factors for sepsis at birth? 1. Rupture of membranes > 24 hours 2. Maternal Intrapartum fever >100.4 3. Chorioamnitis What are some minor risk factors for sepsis at birth? 1. Rupture of membrane >12 hrs 2. Maternal intrapartum fever >99.5 3. Maternal WBC >15,000 4. Low apgar score (<5 at 1 min; <7 at 5 min) 5. Low birthweight - <1500 6. Preterm Labor - <37 weeks What blood work changes will you see with neonatal sepsis? 1. Leukopenia (TLC <5000) 2. Neutropenia (ANC >1800) 3. Immature neutrophil to total neutrophil (I/T ratio) How do you evaluate a symptomatic infant for sepsis? Sepsis Screen: 1. CXR - pneumonia 2. BC's 3. CSF Cultures - meningitis Then, begin antibiotics! Treat pneumonia Treat septicemia Treat meningitis How do you evaluate an asymptomatic infant for sepsis? Sepsis Screen: BC's LPuncture & Cultures Negative - Treat for 48-72 hrs and discharge Positive - Treat septicemia and meningitis for 21 days. What are the best choices for antibiotics? Pneumonia or Sepsis - PCN + Aminoglycoside (Gentamycin or Amikacin) Meningitis - Ampicillin + Gentamicin OR Cefotaxime + Gentamicin or Amikacin. [Show Less]
- Exam
- $12.45
- 0
- 140
Neonatal Exam, questions and answers, with rated solutions
Neonate Terms -antenatal: before birth -postnatal: after birth -perinatal: around the time of birth -neonatal: first 28 days of life Gestation ... [Show More] -term: 37-41 weeks -post term: 41w+ -late preterm: 34-36 weeks -mod preterm: 32-33 weeks -very preterm: <32 weeks -extremely preterm: <25 weeks Trimesters -Week 1- week 12: embryological phase -wk 13-27: foetus phase -week 28-birth: 3rd trimester Weight terminology -LGA: weight >90% at GA -AGA: normal birth weight -SGA: weight <10% at GA -LBW & ELWB: <1000gm weight below defined limit at GA What is a neo puff? Flow dependent resusitator delivering breaths manually with accurate peak pressures (PIP) and end pressures (PEEP) What is IUGR? Poor maternal nutrition & lack of 02 supply to foetus Foetal circulation -Gas exchange occurs -Foetal CVS highly 02 blood delivered to myocardium & brain -Comprised of placenta, 2 umbilical arteries and 1 umbilical vein -Foetus PA02 of 25-30mmHg Foetal circulation steps 1. Foetal Hb maintains 02 delivery despite decreased partial pressures 2. Blood with increased 02 flows to vital organs 3. Foetus has decreased metabolic & 02 consumption and does not require energy to maintain thermoregulation 6 core principles of FCC 1. Listening & respecting 2. Flexibility 3. Sharing of info 4. Providing formal & informal support systems 5. Collaboration at all levels 6. Recognising & building strengths of individuals & families Kangaroo care Principles - prem infants held by mothers 24 hrs a day -thermoregulatuon: baby's temp relies on mother -regulates baby's resps & HR, decreased apenic episodes Goals of developmental care -infant goals: reduce stress, conserve energy, enhance recovery, promote growth and well-being -family goals: support parents in caregiver role, enhance family emotional & social wellbeing Risk factors for RDS Premature infants increase risk for severe respiratory distress RF include: low gestation, male, maternal diabetes, cesarean, PIH Diagnosis of RDS - increased RR - subcostal & sternal retractions -cyanosis -grunting -bilateral decrease in breath sojnds Prevention of RDS -antenatal steroids -prevention of asphyxia -CPAP Management of RDS -surfactant treatment -CPAP/ mechanical ventilation -nutrition -AB's -thermoregulation - 02 & fluids Neonatal liver at birth - iron stores are dependent on maternal stores - ready supply of glycogen -vit k not available -metabolises bilirubin Jaundice definition -manifestation of bilirubin in tissues of body -appears after level of 5mg/dl Types of Jaundice -Pathological: visible <24hrs of age -Physiological: 24hrs- 10 days of age -Obstructive: >10 days of age Pathological Jaundice cause -Deposition of bilirubin in the dermal and subcutaneous tissues and the sclera -Haemolytic disease: ABO incompatibility rH disease Physiological Jaundice cause -Mild increase in bilirubin (risk of brain damage with persistent high levels) -increased bilirubin production -impaired hepatic uptake & excretion of BR -reabsorption of BR in small intestine Late onset Jaundice cause -idiopathic neonatal hepatis -hep B -bilary atresia -bile duct stenosis -galactosaemia Treatment of Jaundice -phototherapy, exchange transfusion -light enhances bilirubin excretion Hypoglycaemia complications -congenital anomalies -prematurity -perinatal asphyxia -RDS -low iron stores -hypercalcaemia & hyperbilirubinemia Hypocalceamia definition -evident 48-72 hours post birth -severity and duration of maternal diabetes -failure of IDM to gather hormone response -increased levels of calicitonin & alternations in vit D metabolism Neonatal abstinence syndrome Behaviour & physiological signs & symptoms that are simulcast despite differences in properties of causative agents 2 types of NAS 1. Perinatal or maternal use of substances that result in withdrawal symptoms in newborn 2. Secondary to discontinuation of meds Complications of NAS -poor interuterine growth -prematurity -foetal distress -still birth -malformations Common substances that cause NAS -opiates -alcohol -tobacco -benzodiaz -SSRI's -amphetamines -cocoaine -marijuana Finnegqn definition Measures baby withdrawal symptoms: commended 2 hrs after birth & 4-6hourly Necrotising enterocolitis definition Necrotic bowel: occurs in formula fed LBW babies Nutrition in preterm -growth -resistance against infection -neuro & cognitive development -decrease morbidity Limitations to neonate nutrition -Minimal nutrient stoes -functional immaturity -diminished suck swallow coordination -gastrointestinal immaturity World BF charter five principles -Human Right -Healthy for babies -Empowers Women -Nature's way Human Milk Formula Properties -Increases protein, energy, calcium & phosphorus -Decreases volume -Increases calories & weight gain Nutritional requirements for neonates -Vit A, D & C -Iron -Folic acid -Calcium & phosphate Maternal risk factors for prematurity -previous prem birth -twins/triplets -smoking/narcotics -poor nutrition -infections or diabetes Preterm infant characteristics -<2500gms -plethoric skin -surface veins -weak cry Thermoregulation complications in ELBW -lack brown fat stores -high body surface area to body weight ratio -non-keratinised skin -lack glycogen supply RDS risk in ELBW babies -surfactant deficiency resulting in alveoli collapse -air leak syndromes -CLD -bronchopulmonary dysplasia -ROP Neonatal Sepsis Definition -Body's inflammatory response to infection by injuring own tissues & organs -occur in 1-8 per 1000 live births -preterm at risk due to immunodeficiency Intrauterine Environment Definition Protects fetus from pathogens-cells are exchanged through placenta Extrauterine Environment Definition Birth canal is not sterile and therefore exposed to a verity of microorganisms after delivery Maternal risk factors for sepsis -Dehydration -Fever & stress -UTI in delivery (chorio) -peripartum infection Foetal risk factors for sepsis -Prolonged rupture of foetal membranes -Break in amniotic sac Common sepsis microorganisms -GB streopoccocus -Escheria coli -Coagulase-negative stephyloccucus -Haemophyllis influenzae -Listena monocytogenes Signs of Sepsis -Pallor -Lethargy -Jaundice -Fever -Hypothermia/ temp instability -hypo/hyperglycemia Risk factors for Neonate Respiratory Failure -Antenatal stress -congenital anomalies -multiple gestations -immaturity of immune system Risk factors for neuro conditions in neonates -O2 deprivation -Infant Jaundice -Physical trauma -Infection IVH definition -Bleeding into the ventricles of the brain -Germinal matrix (fragile capillaries) in prem babies -Prem brain lacks ability to autoregulate cerebral BP -More common in babies with RDS (unstable BP) IVH Grading System Grade 1: hemorrhage confined to germinal matrix Grade 2: extension of hemorrhage into lateral ventricles without hydrocephalus -Grade 3: Ventricular hemorrhage with presence of associated hydrocephalus -Grade 4: Parenchymal hemorrhage Neonatal Seizures Definition -paroxysmal EEG activity with motor changes & autonomic/behavioural clinical signs -include effects on respiration, HR & BP Seizure Management Steps 1st: phenoburbitone 2nd: phenytonin 3rd: midazolam infusion Therapeutic hypothermia Definition -Reduces cerebral metabolism & ATP consumption to down regulate many intracerebral metabolic processes -Limits damage of acute injury -<35degrees to impair normal metabolic, muscular & cerebral function High flow NP 02 Defintion -provides 02 & CPAP to babies with resps distress -2L/kg/min until pressure of 2-8cm of water is achieved CPAP & Bubble CPAP definition CPAP -decreases resp effort -prevents alveolar collapse (conserves energy) Bubble -maintains lung vol during expiration -humidified Basics of neonatal ventilation -Appropriate oxygenation (affected by several factors): FI02, MAP & area of diffusion across gas exchange surface -Appropriate ventilation: amount of C02 exchange at alveolar level [Show Less]
- Exam
- $12.45
- 0
- 199
Chapter 42 - Neonatal Care questions and answers
1. Which of the following is NOT an antepartum risk factor that increases the potential that a newborn may require resuscitation? A) Preeclampsia B) Prol... [Show More] apsed cord C) Polyhydramnios D) Multiple gestations B) Prolapsed cord 2. The risk of newborn complications is HIGHEST if the amniotic sac: A) encases the baby's face at birth. B) is still intact at the time of birth. C) contains thin, brown amniotic fluid. D) ruptured more than 18 hours before birth. D) ruptured more than 18 hours before birth. 3. Which of the following events is a critical part of fetal transition? A) Diversion of blood flow to the fetus's lungs B) An acute increase in intrapulmonary pressure C) Fetal lung expansion within 5 minutes after birth D) Blood flow diversion across the ductus arteriosis A) Diversion of blood flow to the fetus's lungs 4. Causes of delayed fetal transition include all of the following, EXCEPT: A) acidosis. B) hypothermia. C) birth at 41 weeks. D) meconium aspiration. C) birth at 41 weeks. 5. A newborn born between ___ and ___ weeks of gestation is described as term. A) 36, 38 B) 38, 42 C) 40, 42 D) 42, 44 B) 38, 42 6. A delay in clamping the umbilical cord and keeping the baby below the level of the placenta can result in fetal: A) anemia. B) hypovolemia. C) exsanguination. D) polycythemia. D) polycythemia. 7. While preparing equipment for newborn resuscitation, which of the following items is/are NOT considered optional? A) Pulse oximeter B) Cardiac monitor C) Endotracheal tubes D) Laryngeal mask airway C) Endotracheal tubes 8. Which of the following statements regarding the Apgar score is correct? A) If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation. B) The Apgar score is determined on the basis of the newborn's condition at 2 and 10 minutes after birth. C) If resuscitation is needed, it should commence immediately after you obtain the 1-minute Apgar score. D) A newborn with a heart rate of greater than 80 beats/min would be assigned a score of 2 on the Apgar score. A) If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation. 9. According to the Apgar score, a newborn with a heart rate of 80 beats/min and slow, irregular breathing should receive a combined score of: A) 2. B) 3. C) 4. D) 5. A) 2. 10. An infant born with a pink body and blue extremities, a pulse rate of 90 beats/min, a strong cry, and active movement should be assigned an initial Apgar score of: A) 5. B) 6. C) 7. D) 8. D) 8. 11. If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon: A) pulse rate, activity, and appearance. B) respiratory effort, pulse rate, and color. C) appearance, skin color, and muscle tone. D) respirations, appearance, and muscle tone. B) respiratory effort, pulse rate, and color. 12. The initial steps of newborn resuscitation include: A) free-flow oxygen. B) proper positioning. C) assessment of pulse rate. D) positive-pressure ventilation. B) proper positioning. 13. If you feel 13 pulsations in a 6-second time frame, the newborn's heart rate is approximately: A) 30 beats/min. B) 60 beats/min. C) 90 beats/min. D) 130 beats/min. D) 130 beats/min. 14. The MOST common etiology for bradycardia in a newborn is: A) severe hypoxia. B) untreated acidosis. C) occult hypovolemia. D) increased vagal tone A) severe hypoxia. 15. A newborn with central cyanosis, adequate respirations, and a heart rate of 120 beats/min should initially be treated with: A) continued observation only. B) high-flow oxygen via mask. C) free-flow oxygen at 5 L/min. D) positive-pressure ventilation. C) free-flow oxygen at 5 L/min. 16. Choanal atresia is defined as a: A) small chin that causes a posteriorly positioned tongue. B) condition in which high-flow oxygen causes blindness. C) bony or membranous obstruction of the back of the nose. D) condition in which the occipital skull is abnormally large. C) bony or membranous obstruction of the nose 17. An oropharyngeal airway would MOST likely be indicated for a newborn with: A) gasping respirations. B) Pierre Robin sequence. C) a diaphragmatic hernia. D) prolonged periods of apnea. B) Pierre Robin sequence. 18. A newborn with a pulse rate of 80 beats/min: A) requires ventilations and chest compressions. B) should be treated with 0.02 mg/kg of atropine. C) is likely under the influence of maternal opiates. D) requires immediate positive-pressure ventilation. D) requires immediate positive-pressure ventilation 19. The MOST common device used to provide positive-pressure ventilation to a newborn in the prehospital setting is a: A) T-piece resuscitator. B) self-inflating bag-mask device. C) flow-inflating bag-mask device. D) manually triggered ventilator. B) self-inflating bag-mask device 20. Common causes of respiratory distress in the newborn include: A) mucous obstruction of the nose. B) unrecognized metabolic alkalosis. C) persistent pulmonary hypotension. D) maternal use of a narcotic analgesic A) mucous obstruction of the nose 21. Compared to subsequent breaths, the first few positive-pressure breaths delivered to a distressed newborn: A) should provide a volume equal to 40 to 45 mm Hg. B) should make the chest rise significantly. C) may necessitate manual disabling of the pop-off valve. D) generally require a significantly lower volume of air. C) may necessitate manual disabling of the pop-off valve. 22. The correct positive-pressure ventilation rate for an apneic newborn is: A) 12 to 20 breaths/min. B) 20 to 30 breaths/min. C) 30 to 40 breaths/min. D) 40 to 60 breaths/min. D) 40 to 60 breaths/min 23. The MOST common reasons for ineffective bag-mask ventilations in the newborn are: A) equipment malfunction and a ventilation rate that is too rapid. B) inadequate mask-to-face seal and incorrect head position. C) hyperflexion of the newborn's head and thick mucous plugs. D) pneumothorax and a face mask that is too large for the infant. B) inadequate mask-to-face seal and incorrect head position. 24. Endotracheal intubation is clearly indicated in the newborn if: A) its heart rate is improving, but only because of adequate ventilations and chest compressions. B) meconium is present in the amniotic fluid and the newborn is limp and has a heart rate of 70 beats/min. C) central cyanosis is persistent despite the administration of free-flow oxygen for 30 to 45 seconds. D) a small, 27-gauge IV line is present and epinephrine is required to treat refractory bradycardia. B) meconium is present in the amniotic fluid and the newborn is limp and has a heart rate of 70 beats/min 25. What size and type of laryngoscope blade is recommended for use in a full-term newborn? A) No. 1, straight B) No. 2, straight C) No. 1, curved D) No. 2, curved A) No. 1, straight 26. When suctioning the newborn's oropharynx to clear secretions prior to intubation, it is MOST important to: A) limit suctioning to 15 seconds. B) use a flexible suction catheter. C) monitor the newborn's heart rate. D) assess pulse oximetry and capnography. C) monitor the newborn's heart rate. 27. Signs of a diaphragmatic hernia include all of the following, EXCEPT: A) a scaphoid or concave abdomen. B) bilaterally absent breath sounds. C) noted increased work of breathing. D) audible bowel sounds in the chest. B) bilaterally absent breath sounds 28. After inserting an orogastric tube in a newborn, you should: A) leave the 20-mL syringe attached. B) perform intubation within 2 minutes. C) connect the tube to continuous suction. D) leave the tube open to allow air to vent. D) leave the tube open to allow air to vent. 29. Chest compressions are indicated in the newborn if its heart rate remains less than ____ beats/min despite effective positive-pressure ventilations for ____ seconds. A) 80, 30 B) 60, 30 C) 60, 60 D) 80, 60 B) 60, 30 30. When performing chest compressions on a newborn, you should: A) compress the chest one third the anteroposterior depth of the chest. B) use the two-finger compression technique if two rescuers are present. C) reassess the newborn's heart rate after every 60 seconds of compressions. D) deliver 120 compressions and 40 ventilations during any 60-second period. A) compress the chest one third the anteroposterior depth of the chest. 31. If a newborn requires epinephrine and peripheral venous access is unsuccessful, you should: A) cannulate the umbilical vein. B) insert an IO catheter. C) perform intubation immediately. D) inject the drug directly into a vein. A) cannulate the umbilical vein 32. Epinephrine is indicated during newborn resuscitation if: A) the heart rate does not increase above 80 beats/min after 30 to 60 seconds of effective positive-pressure ventilation. B) the newborn is bradycardic and thick secretions are hindering your ability to provide effective positive-pressure ventilations. C) the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions. D) profound central cyanosis persists despite 30 seconds of effective positive-pressure ventilation with 100% supplemental oxygen. C) the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions. 33. The recommended IV dose and concentration of epinephrine for the newborn is: A) 0.01 mg/kg, 1:1,000. B) 0.3 to 1 mL/kg, 1:10,000. C) 0.01 to 0.03 mg/kg, 1:1,000. D) 0.1 to 0.3 mL/kg, 1:10,000. D) 0.1 to 0.3 mL/kg, 1:10,000 34. Signs of hypovolemia in the newborn include all of the following, EXCEPT: A) persistent pallor. B) weak central pulses. C) persistent acrocyanosis. D) persistent bradycardia. C) persistent acrocyanosis 35. If hypovolemia is suspected or confirmed, you should administer ____ mL of normal saline to a 6-pound newborn over a period of ____. A) 18, 10 to 20 minutes B) 27, 5 to 10 minutes C) 33, 10 to 20 minutes D) 55, 5 to 10 minutes B) 27, 5 to 10 minutes 36. How much naloxone should you give to a 6.5-pound newborn with respiratory depression secondary to maternal narcotic administration? A) 0.3 mg B) 0.4 mg C) 0.5 mg D) 0.6 mg A) 0.3 mg 37. Naloxone is NOT recommended for use in newborns: A) who weigh less than 5.5 lbs. B) who are born to narcotic-addicted mothers. C) unless the umbilical vein has been cannulated. D) with shallow breathing and persistent bradycardia. B) who are born to narcotic-addicted mothers. 38. A shift of heart tones and severe respiratory distress despite positive-pressure ventilations is indicative of: A) a pneumothorax. B) a diaphragmatic hernia. C) Pierre Robin sequence. D) a pericardial tamponade. A) a pneumothorax 39. A newborn is at GREATEST risk for meconium aspiration if he or she: A) is large for his or her gestational age. B) requires positive-pressure ventilations. C) has respiratory depression at the time of birth. D) is born at more than 42 weeks' gestation. D) is born at more than 42 weeks' gestation. 40. In contrast to primary apnea, secondary apnea: A) is characterized by profound tachycardia. B) commonly follows a brief period of hypoxia. C) is usually unresponsive to stimulation alone. D) necessitates immediate endotracheal intubation. C) is usually unresponsive to stimulation alone. [Show Less]
- Exam
- $14.95
- 0
- 117
Neonatal Ventilation questions and answers latest 2023
initial PIP for neonatal mechanical ventilation: 15-20 cmH20 initial tidal volume for neonatal ventilation: 4-6 ml/kg how should FiO2 be se... [Show More] t for infants? titrate to maintain lowest required PaO2 and SpO2 for gestational age (PaO2 >50 mmHg) what rate should infant ventilator be set at? 30-60 bpm (adjust to maintain PaCo2 and pH infant flow rate: 6-10 L/m infant itime: .35-.45 seconds (keep ratio 1:1) normal newborn breathes with an I:E ratio of: 1:1.5 to 1:2 What happens to I time when flow rate is increased Shorter itime Increased cpap causes better oxygenation by increasing what? MAP What can too much peep cause May impede ventilation and increase co2 What will an increase in PiP result in Larger tidal volumes and better ventilation What will a slower flow rate result in Increased itime What can contribute to an unstable FRC in neonates Increased airway closure, impaired gas exchange, low lung compliance, high resistance , compliant chest wall Stiff lungs Prone to collapse even in absence of disease Describe how correctly sized nasal prongs fit a neonate They completely fill the lumen of the nares without stretching them What is the ultimate goal of mechanical ventilation Support the patient until the underlying problem is resolved What are the goals of NcPAP NIV and NIPPV Maintain adequate pulmonary gas exchange Optimize comfort Reduce WOB Do no harm What things contribute to fragile neonatal pulmonary lung mechanics Immature respiratory control center Small size of airways Incomplete alveolarisation Immature surfactant production No collaterals pathways of ventilation until age 3-4 Unstable FRC and chest wall Small muscle mass What is the metabolic rate of neonates 7 ml/kg/min (2x as much as adults) How does the high metabolism of neonates effect O2 consumption There is less reserve if O2 consumption needs are increased due to critical illness What might a very low birth weight preterm infant pH goal be 7.25 65 Sao2 greater than 86% For lung protection A persistent pulmonary hypertension patient would have what mechanical ventilation goals Ph great than 7.45 Co2 less than 30 Pao2 of 100 Goal is pulmonary vasodilation List methods used to prevent lung injury Avoidance of mechanical ventilation (use NIV) Permissive hypercapnia Surfactant replacement Optimization of lung volume/avoidance of atelectasis Limit exposure to high fio2 Avoid excess Vt Volume targeted ventilation High frequency ventilation What changes should be considered for elevated PaCO2? Verify et tube position and patency Increase rate by increments of 5-10 bpm Increase PIP by increments of 2 cm h2O to achieve chest expansion and tidal volume Ensure sufficient etime Reduce peep if lungs are hyper inflated Consider sedative or muscle relaxant with MD Transilluminate, rule out pneumothorax What changes should be considered for a reduced PaO2 Verify ET tube position and patency and validate ABG Increase fio2 3-5% at a time to required fio2 Increase itime to .4-.6 seconds, maintain I:E greater than 1:1 Increase peep to achieve higher Paw Increase PiP to deliver optimal tidal volume When units fill and empty rapidly and compliance is low, the time constant will be (short/long) Short A patient with a short time constant would require what kind of settings High rate low tidal volume the lung units fill and empty slowly when there is increased _________ resistance if resistance is high and compliance is normal the time constant will be (long/short) long how will you adjust the rate for a patient with a long time constant may need to set a low rate to allow sufficient time to completely inflate and deflate lung how do you calculate time constant TC = Resistance x Compliance in a patient with a time constant of .25 sec, _______% of passive exhalation or inhalation occurs in 0.25 sec 63% resistance is _______ and compliance is ________ the time constant will be short. normal poor resistance is ______ and compliance is ________ the time constant will be long. high normal how many time constants results in 95% filling and emptying in normal lungs 3 time constants inspiratory time constant of less than 3 may result in: incomplete delivery of tidal volume how would you resolve incomplete delivery of Vt? prolong the itime what is indicated if the expiratory flow waveform is short and steep the patient has a short time constant what is auto peep incomplete emptying of the lung before the ventilator gives the next breath what are 2 techniques for minimizing auto-peep decrease airflow obstruction modify the ventilation pattern what steps can be taken to decrease airflow obstruction in an effort to minimize auto-peep suction to remove scretions bronchodilation possible steroids for mucosal edema how can you modify the ventilation pattern in an effort to minimize auto-peep? extend exp. time (if all airway clearance has already been done) recommend narcotics to decrease pts respiratory drive and slow the respiratory rate (not always appropriate to decrease I-time) patient-ventilator interaction is the relationship between what 2 respiratory pumps? patients pulmonary system ventilator what are the 4 phases of a breath 1) trigger mechanism 2) inspiratory-flow phase 3) breath termination 4) expiratory phase what type of patients are particularly prone to developing auto peep? patients with obstructive lung disease what influences the triggering of a breath? trigger sensitivity setting patient effort valve responsiveness PTP (pressure time product) What factors make for the most limitation with neonatal ventilation? presence of leaks and uncuffed tubes Add or Remove Terms [Show Less]
- Exam
- $12.95
- 0
- 148
Neonatal Sepsis questions and answers, graded A+
What is neonatal sepsis? - a bloodstream invasion by bacteria or the toxic materials produced by bacteria - a major cause of morbidity & mortality ... [Show More] When does neonatal sepsis usually occur? less than 36 weeks gestational How often does neonatal sepsis occur? 1 in 8 infants What are some risk factors for developing neonatal sepsis? - immature barrier defense mechanism - a deficient immunologic response - increased use of instrumentation - prenatal or perinatal exposure - increased length of hospital stay Maternal Conditions that predispose neonates to sepsis - prolonged rupture of membranes longer than 24 hours before birth - extent of life support procedures required postnatally Which are the most common bacterial causes of neonatal sepsis? "GEL" - Group B. Streptococci - E. coli - Listeria What are the most common viral causes of neonatal sepsis? - Herpes Simplex Enterovirus - Adenovirus What is the most common fungal cause of neonatal sepsis? Candida What are the most common protozoal causes of neonatal sepsis? - Malaria - Borrelia Early-Onset Neonatal Sepsis - occurs within the first 3 days of life - more common in neonates weighing less than 1.5 kg (a.k.a. 1500 g) What is the mortality rate of early-onset neonatal sepsis in preterm infants? 60% How can early-onset neonatal sepsis be contracted? - transplacental hematogenous spread throughout pregnancy - direct fetal exposure to organisms when passing through the birth canal - perinatal vertical transmission from the birth canal to the amniotic sac - extra-uterine exposure immediately after delivery What organisms are usually responsible for the hematogenous transmission of early-onset neonatal sepsis? "His Last Relationship Cost Tom Victoria Secret" - Human Immunodeficiency Virus (HIV) - Listeria monocytogenes - Rubella - Cytomegalovirus (CMV) - Toxoplasmosis (found in cats) - Varicella zoster - Syphilis What organisms are usually responsible for perinatal/vertical transmission of early-onset neonatal sepsis? "Girl, Call Eve & Pray God Sends Help" - Group B. Streptococci (GBS) - Chlamydia - E. coli - Pseudomonas aeruginosa - Gonococci - Staphylococcus aureus - Haemophilus influenzae The most common causes of early-onset neonatal sepsis are..? "GEL" GBS E. coli Listeria Group B. Streptococci (GBS) - gram (+) diplococci - colonizes the genital or lower GI tracts - most prevalent in AA women & Diabetes Mellitus patients Maternal Risk Factors for GBS - previous delivery of infant with invasive GBS infection - GBS bateriuria during pregnancy - delivery at less than 37 weeks gestation - duration of ruptured membranes greater than 18 hours - intrapartum temperature greater than 38 C (or 100.4 F) What is the process of prophylaxis in GBS? 1) obtain a vaginal or rectal swab between 35 & 37 weeks gestation 2) if cultures are positive or patient's infection has risk factors, treatment should begin during labor GBS Treatment 1) Penicillin - 5 million units IV, then 2.5 to 3 mill IV q 4 h until delivery 2) Ampicillin - 2 g IV followed by 1 g q 4 h - if membrane is ruptured, 2 g IV followed by 1 g q 6 h until delivery 3) Cefazolin - 2 g IV followed by 1 g q 8 h until delivery How do you treat GBS if the patient has a PCN allergy? Clindamycin - 900 mg IV q 8 h until delivery - studies have shown potential for resistance development E. coli - 2nd most common cause of early-onset neonatal sepsis - colonizes in the cervix and GI tract Maternal Risk Factors for E. coli - UTIs - intrapartum fever - prolonged membrane rupture - assisted delivery - multiple births E. coli Treatment 1) Ampicillin - 2 g IV q 6 h 2) Erythromycin - 250 mg IV q 8 h for 48 hours followed by po doses of these ABX for 5 days What is the salt form of Erythromycin that is contraindicated in pregnancy? Estolate (causes hepatitis) Late-Onset Neonatal Sepsis - occurs more than 3 days postpartum - community-acquired - 93% occur in infants weighing less than 1.5 kg (a.k.a. 1500 g) The most common causes of late-onset neonatal sepsis are..? - Coagulase-negative Staphylococci (Staph. epididermis) - Gram-negative Bacilli - Candida species - GBS What are the most common causes of late-onset neonatal sepsis in VLBW ("very low birth weight") neonates? - Candida - Coagulase-negative Staphylococci What are the clinical manifestations of late-onset neonatal sepsis? - feeding intolerance - respiratory distress - apnea - bradycardia - lethargy - temperature instability - glucose intolerance - hyperbilirubinemia How often should a neonate feed? Breast = 2 to 3 hours Formula = 3 to 4 hours When can a diagnosis of diabetes be made on a child? Type 1 = greater than 2 years of age Type 2 = 10 to 12 years of age [Show Less]
- Exam
- $10.45
- 0
- 156
Prenatal and Neonatal, questions and answers, latest updated
Which is NOT a period of prenatal development? Fetus Embryo Zygote Conception Conception Which of these babies is preterm? A baby born at 36 w... [Show More] eeks. A baby weighing 3 lbs. when born at 39 weeks. A baby weighing 7 lbs. when born at 37 weeks. A baby born at 32 weeks. A baby at 32 weeks Around what week are fetal movements first felt by the mother? 9 weeks 18 weeks 24 weeks 30 weeks 18 weeks Which of the following describes the palmar reflex? The newborn will turn its head when a cheek is stroked. The newborn will grasp a finger placed in its hand. The newborn will look like its walking when held up by the arms. The newborn will rhythmically suck a finger placed in its mouth. The newborn will grasp a finger placed in its hand. What is the treatment for babies with respiratory distress syndrome? Suction the airway every five minutes to clear mucus. An oxygen mask is placed on the baby's face until the baby can breathe on its own. The baby is placed on a respirator. Turn the baby upside down and firmly pat the baby's back. The baby is placed on a respirator What is the earliest point where a fetus has a chance of surviving outside the womb? 10 weeks 18 weeks 25 weeks 38 weeks 25 weeks Which of the following is NOT true of Sudden Infant Death Syndrome? Death occurs in babies that seem to be healthy. The infant dies during sleep. Typically occurs between the ages of six months and one year. Parents and caregivers are in no way responsible. Typically occurs between the ages of six months and one year What forms during the zygote period to cushion and protect the zygote? Amnion Placenta Ectoderm Umbilical cord Amnion Which is NOT true of the embryo period? Lasts from the 3rd to the end of the 8th week of pregnancy The embryo can respond to touch The embryo is about the size of an orange Facial features, arms, and legs form and grow The embryo is about the size of an orange According to the Apgar scale, what score represents the healthiest newborns? 0 to 3 4 to 6 7 to 10 11 to 15 7 to 10 In which of the following situations is a fetus NOT exposed to a teratogen? Drinking caffeinated soda Having a dental X-ray Maintaining vigorous exercise Drinking wine Maintaining vigorous exercise What is fetal alcohol syndrome? Serious birth defects caused by drinking alcohol during pregnancy A set of impairments common to children born to alcoholic fathers An impaired immune system caused by exposure to alcohol A disorder that can be caused by drinking as little as one glass of wine during pregnancy Serious birth defects cause by drinking alcohol during pregnancy Which of the following is true of the newborn states of arousal? The states of arousal include six stages. Irregular sleep is deep sleep with little body activity or eye movement. The states of arousal describe the cycle of sleeping and alertness. The states of arousal describe the baby's ability to differentiate tastes. The states of arousal described the cycle of sleeping and alertness. Which of the senses is least developed in newborns? Vision Taste Touch Hearing Vision Which is true of the zygote period? The placenta begins to develop to provide food and oxygen The zygote implants itself in the fallopian tube Lasts for the first three months of pregnancy The placenta is attached to the zygote via the mouth The placenta begins to develop to provide food and oxygen When is blood Rh a problem in pregnancy? Both mother and baby and Rh negative Mother is Rh positive and baby is Rh negative Mother is Rh negative and baby is Rh positive Both mother and baby are Rh positive Mother Rh positive and baby is Rh negative Which of the following is true of newborn reflexes? Newborns have control over their reflexes. Abnormalities in the reflexes can indicate brain damage. These reflexes become involuntary over time. Reflexes do not appear until the third week of life. Abnormalities in the reflexes can indicate brain damage. During the embryo period, how many layers of cells develop? One Two Three Four Three [Show Less]
- Exam
- $14.45
- 0
- 127
Purchase the bundle to get the full access instantly
- 3 Million+ Study Documents
- 100% Money Back Guarantee
- Immediate Download Access
Add To Cart
Reviews 0
Bundle Details
$37.45
- Trusted by 800,000+ Students
- 24/7 Money Back Guarantee
- Download is directly available
187
0
Seller Details
